Provider Demographics
NPI:1740733443
Name:MINNIFIELD-STEPHENS, STEFFANIE ANJEL (MS, BCBA)
Entity type:Individual
Prefix:
First Name:STEFFANIE
Middle Name:ANJEL
Last Name:MINNIFIELD-STEPHENS
Suffix:
Gender:
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4537 HERITAGE TRACE PKWY BLDG 11A
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-8921
Mailing Address - Country:US
Mailing Address - Phone:817-442-0222
Mailing Address - Fax:
Practice Address - Street 1:2425 E SOUTHLAKE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6675
Practice Address - Country:US
Practice Address - Phone:817-442-0222
Practice Address - Fax:817-442-0223
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
TX3523103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other